Method and theory of monophasic action potential recording

https://doi.org/10.1016/0033-0620(91)90002-4Get rights and content

Abstract

MAP recordings have been at the cradle of cardiac electrophysiology but only recently, through safer and simpler technology, have gained wider access to clinical electrophysiology. In contrast to conventional electrode catheter recordings, MAP recording devices provide precise information not only of the local activation time but of the entire local repolarization time course as well. Although the MAP does not reflect the absolute amplitude or upstroke velocity of transmembrane action potentials, it delivers highly accurate information on the action potential duration and configuration, including early afterdepolarizations as well as relative changes in transmembrane diastolic and systolic potential changes. Based on available data, the MAP probably reflects the transmembrane voltage of cells within a few millimeters of the exploring electrode. MAPs can be recorded by catheter technique from the endocardial surface and by special probes from the epicardium in the operating room. The contact electrode technique is preferable over suction electrodes because it is safer and simpler to use in patients and because it produces more stable, longer-lasting signals. A modified contact MAP catheter incorporates pacing electrodes and permits simultaneous assessment of action potential duration and refractoriness. This not only facilitates the use of MAP catheters in routine electrophysiological studies but also is important for assessing the voltage-independent effects of antiarrhythmic drugs on refractoriness. MAP recordings offer the opportunity to study, in the in situ heart, a variety of pertinent electrophysiological phenomena including, for example, effects of cycle length changes and antiarrhythmic drugs on action potential duration or the role of afterdepolarizations in the genesis of triggered arrhythmias. Due to vigorous heart beating, movement artifacts may occur and need to be distinguished from true abnormalities in the action potential time course. With these limitations in mind, MAP recordings are a valuable addition to clinical electrophysiological studies.

References (69)

  • MR Franz et al.

    In vitro validation of a new cardiac catheter technique for recording monophasic action potentials

    Eur Heart J

    (1986)
  • J Burdon-Sanderson et al.

    On the time-relations of the excitatory process in the ventricle of the heart of the frog

    J Physiol

    (1882)
  • MH Draper et al.

    Cardiac resting and action potentials recorded with an intracellular electrode

    J Physiol (Lond)

    (1951)
  • E Schütz

    Einphasische Aktionsströme vom in situ durchbluteten Säugetierherzen

    Zeitschr Biol

    (1932)
  • E Schütz

    Elektrophysiologie des Herzens bei einphasischer Ableitung

    Ergebn Physiol Exper Pharmakol

    (1936)
  • K Jochim et al.

    The monophasic electrogram obtained from the mammalian heart

    Am J Physiol

    (1935)
  • LA Woodbury et al.

    Membrane resting and action potentials from single cardiac muscle fibers

    Circulation

    (1950)
  • G Ling et al.

    The normal membrane potential of frog sartorius fibers

    J Cell Comp Physiol

    (1949)
  • BF Hoffman et al.

    Electrophysiology of the Heart

  • M Korsgren et al.

    Intracardiac recording of monophasic action potentials in the human heart

    Scand J Clin Lab Invest

    (1966)
  • SB Olsson et al.

    Right ventricular monophasic action potentials in man. Effect of abrupt changes of cycle length and of atrial fibrillation

    Acta Med Scand

    (1972)
  • SB Olsson

    Right ventricular monophasic action potentials during regular rhythm. A heart catheterization study in man

    Acta Med Scand

    (1972)
  • R Shabetai et al.

    Monophasic action potentials in man

    Circulation

    (1968)
  • S Gavrilescu et al.

    The monophasic action potential of the right atrium

    Cardiology

    (1972)
  • P Puech et al.

    Study of monophasic action potentials of the myocardium by endocavitary approach

    Arch Mal Coeur

    (1974)
  • L Churney et al.

    An improved suction electrode for recording from the dog heart in situ

    J Appl Physiol

    (1964)
  • M Franz et al.

    Simultaneous recording of monophasic action potentials and contractile force from the human heart

    Klin Wochenschr

    (1980)
  • MR Franz et al.

    Localization of regional myocardial ischemia by recording of monophasic action potentials

    Circulation

    (1984)
  • MR Franz et al.

    Monophasic action potential mapping in human subjects with normal electrocardiograms: Direct evidence for the genesis of the T wave

    Circulation

    (1987)
  • ME Runnalls et al.

    Modifications of electrode design for recording monophasic action potentials in animals and humans

    Am J Physiol

    (1987)
  • JC Cowan et al.

    Sequence of epicardial repolarisation and configuration of the T wave

    Br Heart J

    (1988)
  • N Kanaan et al.

    Automated detection and analysis of monophasic action potentials in vivo

    J Electrocardiol

    (1989)
  • H Schaefer

    Theorie des Potentialabgriffs beim Elektrokardiogramm, auf der Grundlage der “Membrantheorie”

    Pflügers Arch

    (1942)
  • H Schaefer et al.

    Der monophasische Aktionsstrom von Spitze und Basis des Warmblüterherzens und die Theorie der T-Welle des EKG

    Pflügers Arch

    (1943)
  • Cited by (191)

    • Noise enhanced the electrical stimulation-contractile response coupling in isolated mouse heart

      2016, International Journal of Cardiology
      Citation Excerpt :

      Second, contraction force (CF), since the force is measured through a suture and a force-transducer placed at the apex of the heart and the heart is composed of several layers of muscle fibers oriented in different directions, and then an approximate measurement of the force of muscular contraction was obtained [15]. To obtain these two variables, an electrical stimulation was applied to the right atrium, in order to induce a depolarization followed by the action potential and a contraction [16]. To the best of our knowledge, this is the first experimental test in whole heart focused on analyzing the contractile response due to electrical stimulation perturbed with Gaussian white noise.

    • Shortening of intraventricular conduction time with rapid ventricular pacing

      2014, Journal of Arrhythmia
      Citation Excerpt :

      MAP signals were amplified at a filter setting of 0.05–500 Hz. Ventricular pacing was performed from the proximal electrode pair of the Franz catheter at twice diastolic threshold strength and a pulse duration of 2 ms. The MAP duration (MAPD) was measured as the interval along a line horizontal to the diastolic baseline, from the steepest part of the MAP upstroke to the level of 90% repolarization (MAPD90) [9]. The right ventricle (RV) was paced at cycle lengths (CLs) of 600, 500, 400, 350, 300, 275, and 250 ms for 120 beats at each CL.

    • Developing a novel comprehensive framework for the investigation of cellular and whole heart electrophysiology in the in situ human heart: Historical perspectives, current progress and future prospects

      2014, Progress in Biophysics and Molecular Biology
      Citation Excerpt :

      Early MAP recordings during cardiac catheterisation procedures were made with a catheter that employed suction onto the endocardium (Olsson et al., 1971). Subsequently most MAP recordings have been obtained using the Franz contact electrode concept in a bipolar configuration (Franz, 1983, 1991; Franz et al., 1986; Moore and Franz, 2007). One Ag–AgCl electrode is in contact with myocardium which is partially depolarised as a result of the pressure contact and a second Ag–AgCl electrode is in contact with the adjacent non depolarised tissue (see Fig. 1).

    • Monophasic action potential duration alternans after abrupt shortening of the cardiac cycle in humans

      2014, Journal of Arrhythmia
      Citation Excerpt :

      Ventricular pacing was performed from the proximal electrode pair of the Franz® catheter at twice the diastolic threshold strength and a 2-ms pulse duration. MAPD was measured as the interval along a line horizontal to the diastolic baseline from the steepest part of the MAP upstroke to the level of 90% repolarization [16]. The right ventricle (RV) was paced at cycle lengths (CLs) of 600, 500, 400, 350, 300, and 275 ms for 120 beats at each CL.

    View all citing articles on Scopus
    View full text